NICE recommends home antibiotic treatment for some babies

Newborn babies receiving antibiotics in hospital could be switched to oral antibiotics and cared for at home, NICE has recommended in updated guidance published today.

NICE suggested the move could enable mothers whose babies need antibiotics to leave hospital sooner – potentially reducing their hospital stay by up to 2.7 days.

The neonatal infection guidance makes clear that babies who are sent home and moved onto oral antibiotics would be monitored by hospital neonatal teams until treatment is complete ‘for safety reasons’ and ‘continuity of care’.

It also explained that this was applicable to babies that were ‘doing well and responding to treatment’.

Newborns are assessed for specific birth related risk factors, including premature births, if the mother has group b strep or sepsis during labour, and if needed will be given antibiotics intravenously.

While some of these babies will need to stay in hospital, the NICE guidance says babies born after 35 weeks can be switched to liquid antibiotics and taken home if they test negative for infection, are stable, feeding well and are responding to treatment.

The approach has been piloted in three projects across nine NHS sites in England successfully. One of the projects named NOAH, which took place in Devon, showed an average hospital stay of 2.7 days per baby.

It is estimated by the NOAH project that up to 12,000 babies a year could benefit from the change if rolled out nationally.

NICE hopes this will bring ‘significant benefits’ to the NHS, including freeing up neonatal beds for babies who need intensive care and easing pressure on the busiest specialist wards.

NICE’s clinical advisor for nursing Lucy Common said: ‘As part of our updated guideline, we specify parents are trained by the neonatal team in how to give their baby antibiotics orally, recommending this must be done under clinical supervision in hospital before they can go home.

‘Crucially, this support continues and we recommend at least two follow-up consultations after discharge to check on the baby's progress.’

Interim director of NICE centre for guidelines Eric Power added: ‘These updated recommendations will improve how some mothers experience the first few days with their new baby.

‘We know the first days with a new baby can be overwhelming, especially if your baby is being treated for a suspected infection.’

Guideline committee member and consultant neonatologist at Evelina Dr Tim Watts added: ‘Rolling this out nationally would mark an important step forward both for families and the NHS.

‘We have seen that babies can complete their antibiotic course just as safely at home as in hospital and that many families prefer settling their new babies in at home.

‘This move would also free up neonatal transitional care and postnatal beds, meaning we can focus our care towards the mothers and babies who truly need to stay in hospital.’

A version of this article was first published on our sister title, Nursing in Practice.